PrEP Provider Toolkit
PrEP Provider Toolkit
PrEP Initiation
Coding for PrEP Visits
Below are the recommended visit codes for PrEP management.
This may vary based on your institution.
- Z20.6Z20.6 (Contact with and (suspected) exposure to HIV)
- Z79.899 (Other long term drug therapy) If PrEP is started or continued
and at least one of the following:
- Z72.5 (high risk sexual behavior) if there are sexual risk factors
- W46.1XXD (contact with contaminated hypodermic needle) if there are IVDU risk factors
Billing:
- If PrEP is the only topic addressed
- 99401 approximately 15 minutes
- 99402 approximately 30 minutes
- 99403 approximately 45 minutes
- 99404 approximately 60 minutes
- If multiple health topics are addressed, use normal billing codes based on complexity (e.g. 99213, 99214)